A Hole in the Heart
by the-blossom-and-the-bee
Summary: AU. Dr. Castiel Novak is a pediatric cardiologist treating eight-year-old Sam Winchester. He meets Sam's big brother and guardian, 23-year-old Dean. They hit it off and both are attracted to the other but because of the situation they need to remain professional to best help Sammy. Cute fluff medical drama. Read & Review!
1. Chapter 1

**A/N: **So this is just an idea that came to me and I thought it could be really cute. More chapters to come!  
Disclaimer: Unfortunately, I'm not the owner of Supernatural or it's characters. Darn.  
Pretty please with cherries on top read &amp; review!

**C****hapter One:**

Dr. Castiel Novak crossed through the employee entrance of Minneapolis Mercy Hospital with a cup of black coffee in his hand, just like any other Thursday morning. Castiel shivered as the cold January air followed him into the building. He took sips of the scalding coffee as he walked to the cardiology wing of the hospital and entered his office. He barely had time to remove his coat and turn on his computer when Emma, one of the nurses, knocked on the door and peeked her head in.  
"Dr. Novak your first patient is ready for you." Nurse Emma informed him. Castiel checked his watch. 8:00 on the dot.  
"Do you have the file?" the pediatric cardiologist questioned.  
Emma handed over a thin manila folder, "he's in room 314 when you're ready."  
Cas nodded. He flipped open the file to reveal a scant amount of info about a young boy, eight years old, who had been referred here by his pediatrician who heard a heart murmur. Dr. Novak scanned the rest of the information quickly before grabbing his stethoscope and heading to room 314.  
The hallways of the hospital were already bustling with nurses, doctors, patients and family members. Castiel walked up to the proper room and rapped his knuckles against the door. As he entered he saw the young patient seated quietly on the exam table, but when Cas looked around the room he didn't see a parent or guardian.  
"Hey buddy, you must be Sam Winchester. I'm Dr. Novak, or you can call me Dr. Cas." Castiel stuck out his handed. The boy nodded and reached out his hand and shook it, giggling the entire time. "Is your mom or dad here with you?"  
Sam nodded again. "He said he got a phone call from the 'surance company. He's in the hallway." Castiel smiled at the child's pronunciation of "insurance."  
"Ok. Well do you know why you're here today?"  
"'Cause you gotta listen to my heart!" The boy's eyes lit up, obviously his parents had done a good job making sure he wasn't scared about coming to a hospital.  
"That's right," Dr. Novak nodded, "Do you know what this is called?" he gestured to his stethoscope. Sam shook his head, making his floppy brown hair whip all around."It's called a stethoscope. Can you say that?"  
"Se-sefoscope?" Sam attempted.  
Castiel couldn't help but love this little boy already. It was sweet little kids like this that made Cas so grateful he decided to become a pediatric cardiologist.  
"This stethoscope makes quiet sounds really, really loud. And I'm going to use it to listen to your heart." Castiel placed the stethoscope in his ears and position the drum over Sam's heart. He moved it around a few times, listening carefully. The boy's pediatrician had been right; there was a definite heart murmur. Now Castiel could only pray this sweet boy didn't have a serious condition.  
"All done. And you did a great job helping me out today!" Castiel praised. He walked over to the built in desk and opened a drawer full of lollipops. "Why don't you come pick one out." Sam climbed off the table and chose a sucker from the drawer. Cas ruffled his hair before reaching for the phone that hung on the wall.  
Emma answered the phone on the other end of the line. "This is Nurse King."  
"Hey Emma, will you come sit in room 314 until Sam's parent gets back. And have them schedule a time to have an echocardiogram with me."  
"Will do." Emma replied.  
"Thanks." Castiel hung up the phone and the nurse reentered the room. "Ok Sam, I have to go. But We're going to see each other really soon." Cas extended his hand to give the boy a high five.  
"Bye Dr. Cas," Sam slapped Castiel's hand and Cas left the room.


	2. Chapter 2

**Chapter Two:**

Four days after Sam Winchester's first appointment Castiel checked his patient list for the day and saw that little Sam was scheduled for an echocardiogram. Castiel hoped that had a good result.  
10:00 rolled around and Cas snatched up Sam's file and marched to the exam room.  
"Hey Sam!" Cas called and the two high fived. Sam rewarded Castiel with a beaming smile. Castiel noticed another person in the room and turned towards what he assumed was Sam's dad.  
Castiel was met with the most intense pair of green eyes he'd ever seen and a face that was much younger than he expected. After doing a double take and clearing his throat Cas reached out a hand which the other man grasped.  
"I'm Dr. Castiel Novak. Sam's pediatric cardiologist."  
"Dean Winchester." The other man responded, smiling at Castiel. "I'm Sam's older brother and guardian."  
_Wow. Sammy's doc is hot, _Dean mused.  
"Sam, today we're going to give you something called an echocardiogram which we use to take a picture of your heart. This is Emma and she's going to take you to get ready, ok?"  
Sam agreed and left the room with the nurse hand in hand.  
"Dean, I'd like to explain this procedure to you before we perform it on Sam."  
Dean nodded, "Yeah I think that's a good idea."  
Cas pulled up two chairs, "take a seat." The two men sat across from each other.  
"So the procedure we're doing is called an echocardiogram, which basically is a specific name for a sonogram done on the heart. I'll start by putting a gel on Sam's chest and then we use a wand to actually scan the area near his heart. The wand emits sound waves, nothing we can actually hear though, and the sound waves bounce off the structure of Sam's heart and will form a picture on the monitor. We'll hopefully be able to use the picture to identify what's causing Sam's heart murmur."  
Dean nodded in understanding, "what is the best case scenario here?" Dean chose his words carefully.  
"The least serious thing we could find would be a faulty valve in his heart, such as a valve that doesn't close all the way. If that's the case Sam would just experience increased lethargy and he would tire more easily than most people. But other than that he would lead a typical life."  
"Well then that's what we're hoping for." Dean said as both men stood up.  
Castiel and Dean walked side by side to the procedure room. The entire stretch, Cas was very aware of Dean's strong, masculine presence.  
When they reached the right room Castiel pulled open the door and held it for Dean. In return, Dean gave him a wickedly handsome smile.  
"I'm warning you Sam, this gel is cold," the doctor cautioned.  
Dean stood by Sam and watched as the doctor performed the process exactly as he explained. However, the man's silence as he looked at the picture of Sam's heart made him nervous.  
When Castiel finished he gave Sam a towel to clean of the gel and suggested he go put his own clothes back on instead of the hospital gown.  
"So…" Dean started, anxiously.  
"Let's step into the hall." Dr. Novak suggested, making Dean even more worried. Castiel had a somber look on his face. "I found an atrial septal defect."  
Dean pursed his lips and nodded, "I have no idea what that is."  
"It's a hole in the wall that separates the two atria in Sam's heart. Sometimes, this isn't a major health issue, but since Sam is already eight and the hole is a large one it probably won't repair itself and he will require surgery."  
Dean was taken aback. He inhaled sharply and ran a hand through his thick, dark blond hair. He took a step back and plopped into one of the cushioned chairs behind him.  
_I hate this part, _Castiel thought. He gently seated himself in the chair next to Dean. He watched a distraught Dean lean forward, resting his elbows on his knees, and put his head in his hands.  
Castiel had never been good at consoling people, he always felt bad about it. But something about Dean nearly ripped Cas apart. Castiel placed a hand on Dean's back, trying to avoid how muscular and strong he felt.  
"Ah I'm sorry Dean. I've done this surgery many times before, and I'll do everything in my power to make Sam healthy again."  
Dean didn't respond. Castiel continued to gently rub Dean's back in consolation. Finally Dean looked up, eyes red and puffy, and locked his eyes with Castiel's.  
"Thank you Dr. Novak," Dean wrapped his arms around the doctor tightly. Cas, shocked by the sudden hug, tried to ignore how perfect the embrace felt. He was completely unaware that Dean was experiencing the same perfection.  
"You can call me Castiel," Cas said, his lips brushing against Dean's ear as they embraced.  
The two men separated their bodies. "Ok, Castiel." Dean gave a half-smile. He liked how the doctor's name felt on his tongue.  
The men locked eyes and grinned at each other for a length of time that was probably abnormal. Castiel coughed and rose quickly from his chair.  
_He's a guardian. Of my patient. This can't happen. _Castiel reasoned to himself.  
"We'll do a few more check-ups and observe Sam over the next month or so and after that we can discuss scheduling an operation." Castiel explained.  
"Thanks again, _Cas._" Dean said.  
_I'm in big trouble, _Dean thought about the attractive physician, _those blue eyes are big, big trouble. _


	3. Chapter 3

**Chapter 3:**

Dean gathered his and Sammy's things. He pulled in his jacket and then wrapped his little brother in a coat.  
"Let's go get some hot chocolate and talk." Dean told Sam.  
"Yay!" Sammy cried gleefully, grasping Dean's much larger hand. The two brothers left the hospital hand in hand and walked to the black '67 Chevy impala that once belonged to their father.  
Sam buckled up in the back seat and Dean climbed into the front. He fired up the engine, checking on Sam in the rear view mirror before reversing out of the parking space. Just a few minutes later Sam and Dean pulled into the local coffee shop a couple of blocks from their apartment.  
Dean exited the vehicle and reached to open Sam's door. The two rushed inside, out of the frosty air. At the front counter Sam ordered two peppermint hot chocolates. With warm drinks in hand, the brothers plopped into two cushy lounge chairs.  
"So champ, I talked to your doc-"  
"Dr. Castiel," Sammy interrupted.  
Dean chuckled and then smiled at the thought of the incredibly good looking man. "Yeah, Dr. Castiel. He told me that in your heart there's a hole, and that can make you kind of sick. So what he's going to do it open up your heart and cover up the hole. That way your heart will work better and you'll be healthy. Make sense?"  
Sam nodded thoughtfully, "But how will he open up my heart?"  
Dean treaded carefully with his answer, hoping not to frighten his brother. "Well Castiel will give you some medicine that will make you go to sleep and then he'll use a really sharp knife to get to your heart, but you won't feel anything and you'll be sleeping the whole time, and then he'll fix the whole."  
Dean saw Sam gulp.  
"Here's the thing, buddy, it's important for you to get this surgery. I need you to be healthy, ok? Because I don't want anything bad to happen to you. Can you be brave, for me?" Dean gripped Sam's shoulder as he spoke.  
"I can be brave, like you Dean." Sam hugged his older brother tightly.  
Dean returned the action. "I know you can. You're a champ. I love you, kiddo."  
"I love you too," Sam tightened his arms around Dean.

The next week Sam and Dean traveled to the hospital again for a checkup to make sure Sam was healthy enough for open heart surgery. Sam was in the room with the nurse while Dean waited in the hallway.  
A hand holding a cup of coffee appeared in front of Dean's face. He saw a handsome doctor when he looked up.  
"I hope you like coffee Dean." Castiel offered the disposable cup to Dean.  
"I do, thanks." Dean answered tiredly.  
"Mind if I…" Castiel's voice trailed off and he pointed to the chair next to Dean, who nodded. "How are you holding up, Dean?"  
"I'm, uh, ok. There's just a lot happening with Sam and I'm so worried and I can't lose him like we did-" Dean cut off his sentence.  
Cas decided not to push him into talking about who he'd lost  
"I'm sorry you and Sam have to go through this. It would be difficult enough but adding on top the fact that you're his older brother, much too young to be going through this as a parent, trying to be the strong one. I'm just so sorry Dean, I really am. And like I told you, I'm doing everything I can to help you and Sam."  
"I really appreciate you saying that Castiel. And thank you for being so good to Sammy. He really likes you."  
Cas laughed, "I like him. That boy is the sweetest thing I've ever met, I don't think I could help but be wrapped around his little finger."  
"Trust me, no one can help that." Dean and Cas shared a smile.  
The two sat in comfortable silence for a moment.  
"After Sam's appointment today we'll schedule another echocardiogram to essentially map out Sam's heart and the hole and we can use it when we do the surgery. Hopefully, we can have the surgery scheduled for some time next week."  
Dean sighed, his eyes wide with anxiety. "It's all happening so fast."  
"I know, Dean. And it can be stressful, but it's better this way. We're taking no chances on Sam getting sick before we can do surgery and risk that opportunity and this way he can heal as fast as possible and you two can get back to your hospital-free life."  
Castiel wasn't sure why, but he felt disappointed at the idea of never seeing Dean again.

**A/N: **Maybe it's just me but I feel like not much happened in this chapter...sorry about the lack of excitement. But I felt like this dialogue was necessary to develop the relationships between characters. Chapter 4 will be posted soon and I promise it's much more interesting. Thanks for reading!


	4. Chapter 4

**Chapter Four:**

Castiel was right. The very next week Sam and Dean drove to the hospital in their impala, both brothers silent with nervousness. Sam's operation was scheduled to begin at 11:00.  
"How you doing buddy?" Dean checked on Sam and glanced in the rearview mirror.  
Sam just looked at Dean in the mirror and smiled.  
The brother's pulled in the inpatient parking lot at a quarter til 11. That entered the hospital and checked in at the reception desk before heading up three floors to the cardiology wing. Dr. Novak met them at the nurse's station.  
"Hey Sammy. You ready to get better?" Castiel asked the small boy.  
Sam shouted "yeah!" and gave Cas a hug.  
Dean was relieved that Sammy wasn't terrified of having his chest cut open.  
Castiel stepped closer to Dean. We have to go prep for surgery. This will take hours, you are aware of that? Plus Sam will still be under for a few more hours once the surgery is over. But I will try to come and let you know how everything goes as soon as the operation is over."  
Dean just nodded, his throat too thick to say anything.  
Castiel took Sam's hand and together they walked to the operation prep room. Sam was put into a hospital gown and hooked up to monitors that measured his pulse, blood pressure, and respirations. Cas put on his surgical scrubs and prepared himself for the surgery.

Dean had been pacing the floor for the past three hours. _How long is this supposed to take? _Dean ran his hands through his hair and continued to pace.  
"Dean?"  
The older brother whipped around and spotted Dr. Novak standing on the other side of the waiting room. Dean jogged over to him.  
"How is he? Is he alright?" Dean's words rushed out of his mouth.  
"He's in recovery now. The surgery seems successful but we won't know for sure for a couple of days when he starts to heal." Castiel explained  
"When can I see him?"  
"He'll still be out for a couple more hours but once he's awake you can be with him."  
"Cas," Dean voice cracked, "I don't know how I'll ever thank you for taking care of my little brother."  
"You don't have to, Dean. Knowing Sammy has been thanks enough," Castiel grinned. "You shouldn't stand here and pace for two more hours. Would you like to get a cup of coffee?"  
"I don't-" Dean almost declined, "no, you're right. I shouldn't pace. I could go for a cup."  
The two men walked together to the hospital cafeteria where they ordered their beverages and sat down in a booth near the back.  
"So Castiel, what made you decide to be a doctor?"  
"That's a very good question." Cas replied.  
Dean squinted at the man across from him, "are you going to answer it?"  
"My entire family, and I mean _entire,_ my father, grandfather, brothers, sister, everyone is a lawyer. My grandfather started a law firm and my father took it over when he retired and now all my siblings work there as well. I just didn't want to be a lawyer, I had no passion or desire for that. My dad never liked it when we went against his will, or did something he didn't approve of. When I told my father I didn't want to be a lawyer he was furious. He blew up on me shouting about family tradition and respect and that made me furious that he didn't, couldn't, accept me. So I wanted to get back at him, somehow. My dad has always hated doctors, he thought they were pretentious and egotistical, ironically enough. So I became a doctor, luckily I loved it for more than the fact my father hated it. I have been so fortunate to have this career that I love so much. I love the work, I love my patients and I love this crazy, stressful, insane life that I have."  
Dean couldn't help but gape as the man. He was so intelligent and beautiful and passionate. Talking about what he loved made his eyes light up and Dean was entranced.  
The men continued to talk until Castiel's pager began to buzz.  
"Sam's awake."  
Dean hopped out of the booth and tossed his empty cup into the trash, "Let's go."

For the next few days Sam rested in the hospital and Dean never left his side. Cas often stopped by to check up on Sam and to talk with the two brothers. Sam was healing up well, he was still tired but Castiel said the murmur in his heart and gone away and his heart seemed to be healing over. It was five days after the surgery and the day Dean was going to take Sammy home. A nurse had come to get Sam ready to check out and Castiel had come by for one last visit.  
"Dr. Cas! I'm going home!" Sammy cried when he saw the physician.  
"I know, buddy. I'm glad you're getting out of here." Cas smiled at the little boy. "Dean, could I speak to you in the hall?"  
Dean glanced back at his little brother before following the doctor into the hallway.  
"Dean, I was wondering if sometime, after Sam is back to his normal self, you'd like to go out to dinner or something."  
Dean stared at Castiel, his face unblinking and emotionless. "Cas," he whispered. "I don't-"  
Castiel interrupted him, "it's fine, I was just wondering."  
"Wait, Cas, it's just, I don't know how well I can commit and I don't want to get involved and then not be able to commit to you and just end up hurting you. My mom died when Sammy was only a month old. Obviously he didn't understand but I was 15 at the time and it hit my dad and I real hard. After that, my dad was sort of absent from our lives. I was 19 and in college when my dad finally had enough and ran out on us. Sammy was four at the time. Losing both of my parents, it made me wary of relationships. Knowing that life is short, and sometimes people choose to leave you it left me broken. Much like Sammy my heart has a hole in it. And now, after all this with Sammy and feeling like I almost lost him, it's just made it worse. And I don't know how to go on from here." Dean nearly broke down, his eyes puffing up and filling with tears. "I'm sorry, Castiel."  
"Dean, I understand."  
Dean turned back and he and Sammy exited the hospital, Dean looking back for one last glance before leaving.

Over the next week both Castiel and Dean thought a lot about the other. Castiel wished it couldn't been different between them and Dean regretting the answer he gave Cas.  
It was late at night, Cas was finishing up paperwork in his dimly lit office when his cell phone rang.  
"Hello?" Cas answered.  
"It's Sam," Dean's voice choked on the other end of the line, "He's in ICU."


	5. Chapter 5

**Chapter Five:**

Cas sprinted out of his office. He crashed down the hallway to the elevator and jammed the button. Impatient, Cas slammed in the door that led to the stairwell and raced down the stairs, taking two at a time. He ran to the ground floor to the ICU. As soon as he entered the wing he spotted Dean who looked like he was about to rip out his own hair.  
"Dean."  
"Cas!" Dean threw himself at the doctor.  
"What happened to Sam?" Cas asked hurriedly.  
"I don't know. It started with a low-grade fever yesterday. And this morning it was really bad, 103 degrees, he was shaking and cold and he had sore, red patches on his hands and feet and I didn't know what to do."  
"It's ok Dean, it's going to be ok. Let me go see what I can do."  
Dean watched as Cas walked through a set of double doors.  
Though it wasn't long until Castiel returned, it had seemed like hours to Dean. Castiel walked back through the same set of doors and waved Dean over.  
The two men walked as Castiel explained the situation. "Sam is suffering from endocarditis. When we did the surgery the tissue in his heart became infected and that's what caused the fever, chills, and sores. We've hooked him up to an IV that will continually administer antibiotics for a few days. Once the treatment is over and his infection has gone he'll be good as new, hopefully for real this time, and you two can be done with this place."  
Dean and Cas entered the room. "Hey, buddy" Dean caressed Sam's floppy hair, "how do you feel?"  
"Sleepy." Sam answered.  
Dean leaned over Sam and hugged him tightly, holding him close, as if that could protect Sam from anything bad happening ever again.

A few days later the brothers once again prepared to leave the hospital, once and for all this time. Both of them were ready to leave. Castiel stopped by once last time to say goodbye to Sam. The doctor and the patient embraced.  
Cas and Dean shared one last smile as Dean packed up their things. Sam and Dean walked hand in hand out of the hospital with Cas beside them. Cas stopped at the main set of doors to watch Sam and Dean leave.  
It hurt Dean's heart to leave Cas again. He had been there, he was so good to him and Sam even after Dean had turned him down. But he just didn't know how he could devote himself to someone. And wonderful Castiel didn't deserve only half of someone, he deserved complete devotion.  
Sam interrupted Dean's thoughts, "I love Dr. Castiel."  
Dean smiled at the sweet boy.  
"Do you love Cas?"  
The innocent question made Dean stop dead in his tracks. _Yes. _His heart screamed. Dean looked back and saw Castiel still standing and watching them. Dean knew. Dean knew that the hurt, the fear, the risk was all worth it, if it was for someone like Castiel. Someone he loved.  
Dean ran back to Castiel as quickly as he could. Grabbing Cas' face in his hand when he reached the doors.  
"Cas. I was wrong, so wrong. It's worth the risk, the hurt, everything. You are worth it, Castiel Novak."  
Castiel beamed at Dean wrapping his arms around the man and they shared a chaste kiss.  
Dean whispered into Cas' ear, his lips brushing the side of the doctor's face. "You healed it, Cas. You healed me. Because of you there is no longer a hole in my heart."

**A/N: **This chapter is kind of short, sorry, but it's all I needed to finish it up. This story turned out so much better than I imagined and I'm just so darn proud of it! I'm still horrible at endings, I think this ending was alright but I'd still LOVE feedback on it and on the whole story overall. Thanks to everyone who read and reviewed. I hope you enjoyed reading it as much as I enjoyed writing!


End file.
